2013
DOI: 10.4174/jkss.2013.84.6.346
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Reconstruction of portal vein and superior mesenteric vein after extensive resection for pancreatic cancer

Abstract: PurposeTumor invasion to the portal vein (PV) or superior mesenteric vein (SMV) can be encountered during the surgery for pancreatic cancer. Venous reconstruction is required, but the optimal surgical methods and conduits remain in controversies.MethodsFrom January 2007 to July 2012, 16 venous reconstructions were performed during surgery for pancreatic cancer in 14 patients. We analyzed the methods, conduits, graft patency, and patient survival.ResultsThe involved veins were 14 SMVs and 2 PVs. The operative m… Show more

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Cited by 21 publications
(14 citation statements)
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References 19 publications
(22 reference statements)
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“…Isolated vein involvement is not a contraindication to resection, with comparable short and long-term outcomes comparable to those of a standard resection [63]. Techniques that can be used for reconstruction of the PV or SMV are wedge resection with venoplasty, end-to-end anastomosis (Figure 3), patches or vein interposition grafts [64,65]. Direct end-to-end anastomosis of the PV system is safe, but when tension-free anastomosis cannot be guaranteed; generally, in cases requiring ≥3 cm of SMV/PV resection, venous autografting may decrease the likelihood of anastomotic stenosis [66].…”
Section: Surgical Treatment: Recent Trends and Advancementsmentioning
confidence: 98%
“…Isolated vein involvement is not a contraindication to resection, with comparable short and long-term outcomes comparable to those of a standard resection [63]. Techniques that can be used for reconstruction of the PV or SMV are wedge resection with venoplasty, end-to-end anastomosis (Figure 3), patches or vein interposition grafts [64,65]. Direct end-to-end anastomosis of the PV system is safe, but when tension-free anastomosis cannot be guaranteed; generally, in cases requiring ≥3 cm of SMV/PV resection, venous autografting may decrease the likelihood of anastomotic stenosis [66].…”
Section: Surgical Treatment: Recent Trends and Advancementsmentioning
confidence: 98%
“…The evidence is that PSMV resection during PD is being performed more often, but there has not been a commensurate decrease in R1/2 margin rate. In some series, the overall R1 rate has increased with PSMV . The most common reason for R1/R2 was a positive SMA margin .…”
Section: Methodsmentioning
confidence: 99%
“…In some series, the overall R1 rate has increased with PSMV. 26,40,42,46,55,63 The most common reason for R1/R2 was a positive SMA margin. 6 Table 2 summarizes the literature that reports R1 rates with and without PSMV resection.…”
Section: Impact Of Venous Resection On Sma Marginmentioning
confidence: 99%
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“…A recent report investigated vascular outcomes based on the type of conduit used, however, the currently available data are limited. 10 The pros and cons of all available options are important to consider in deciding the most appropriate reconstructive option.…”
Section: Improvements In the Resolution Of Multidetector Computed Tommentioning
confidence: 99%